Analysis of Entry Point of Pedicle Screw Placement in the Lumbar Spine

Generally accepted conventional entry point of the pedicle screw is in the midline of the transverse process from cephalad to caudal, and slightly up onto the lateral aspect of the superior articular process. But the combined posterior lumbar interbody fusion(PLIF) do not need to expose the transverse process. Before clinical application, the author studied the insertion point using 5 cadaveric dried lumbar vertebral bodies (50 points). The anatomic landmark was used as the starting point of screw insertion. The author knew the new entry point of lumbar pedicle screw which was the crossing point of the crest of pars interarticularis and the crest of accessory process. After confirming the new entry point of pedicle screw, the author studied 108 patients undergoing pedicle screw fixation by the new entry point, and PLIF with cage insertion from May 1996 to October 1998. Eighty six cases underwent pedicle screw fixation and PLIF, and 22 cases underwent PLIF only. Among 106 patients, 98% of patients had stable fixation. According to modified Odom's criteria, 89% patients were rated as good and excellent at 6 months after operation. There were 4 cases of dural tear, 2 cases of transient nerve root injury, and 2 cases of wound infection. In conclusion, the new entry point provides a safe and accurate without exposure from radiation. So, it will be applied in the fields of minimally invasive spine surgery. Surgeon implanting lumbar pedicle screws should use this new entry point that is alternative methods to obtain accurate entry to the pedicle.

Author dc:creator

• 정, 영선

Contributors dc:contributor

• 조, 기홍
• 대학원 의학과
• 200024435

• 요추경 나사못
• 삽입점
• 외부 표식자
• 후방 요추체 유합술
• 미세 침습 척추 수술

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000001187
000000001187

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/1565